Editor’s note: Today, Wednesday 31 May, marks World No Tobacco Day. Yesterday, Associate Professor Michelle Jongenelis spoke before the Health and Environment Committee on their inquiry into reducing rates of e-cigarette use in Queensland. Read her opening statement below.
Associate Professor Michelle Jongenelis
Thank you for the opportunity to appear before the Health and Environment Committee. It is pleasing to see the Queensland Government take e-cigarette use seriously and investigate ways in which use can be addressed.
The committee is no doubt aware that Federal Minister for Health Mark Butler describes e-cigarettes as a public health menace. Australia’s Chief Medical Officer, Prof Paul Kelly, has declared e-cigarettes to be the next big health issue after COVID. E-cigarettes contain toxic chemicals that are harmful to health, and people who have never smoked but vape are 3x more likely than those who do not vape to initiate tobacco smoking. The harms associated with e-cigarettes are not limited to nicotine exposure. There has been a focus on nicotine, but studies show that it is the additives and flavourings that are particularly harmful.
Preventing increases in vaping and minimising related harms have become public health priorities. Recent announcements by Minister Butler have great potential to address the illegal importation, sale, and distribution of these products. It is pleasing to see the Federal Government take action to ensure these products are accessible to those who may benefit, while protecting those for whom use has multiple harms.
It is important that States support the Federal Government in their efforts, and it is excellent to see that Queensland has recently committed to implementing a positive licensing scheme. This will make is easier to enforce legislation. However, further action at the State level is needed if we are to protect Australians from an industry that is determined to maintain its profits. It is critical that all states, including Queensland:
- prohibit the supply of all e-cigarette products, regardless of nicotine content, except by pharmacies
- bolster monitoring and enforcement to address illegal retail sale of e-cigarette products
- ban all forms of advertising, promotion, and sponsorship of e-cigarette products
- ensure ongoing community education and support for those wanting to quit
Proponents of a consumer model will argue that e-cigarettes should be as available as cigarettes. This is short-sighted. We should be reducing the accessibility of cigarettes, not introducing another harmful product into society, and it is pleasing to see that both the Federal and QLD State Governments have committed to taking action on smoking.
E-cigarettes are not a panacea for smoking cessation. While use may be beneficial for those who use the products to quit smoking completely and promptly, this is not the reality. Research has shown that among those who use both e-cigarettes and tobacco cigarettes, 55% will go back to exclusive cigarette use 2 years later, 26% will continue to be using both products 2 years later, and just 12% will have switched completely to e-cigarette use. This means that for the vast majority of smokers, e-cigarette use does not assist with cessation. We should not be condemning a new generation to nicotine addiction based on these so-called success rates. The reality is that we will soon be in a situation, if we aren’t already, where the number of non-smokers who take up vaping outnumbers the smokers who will successfully quit smoking using these products.
Further to this, in recent research I conducted on 12+ year olds, only a quarter of smokers said they started vaping to quit smoking. This means that the vast majority are not using e-cigarettes to quit. So, the vast majority of smokers are not using these products to quit smoking and only 12% of those who are using these products to quit smoking are successful, but are still addicted to vaping 2 years later. These are not promising figures and yet these figures are being used to argue for widespread availability. These are the figures being used to argue for why the harmful products should be sold in convenience stores. This is unnecessary. There is a pathway in place that provides smokers who want to quit with access to products. Importantly, this involves going to the GP, where they can receive behavioural support to quit also. This is critical – behavioural support increases the chances of successfully quitting smoking. If we allow these products to be sold by retailers, they won’t be receiving this behavioural support.
The other argument being made is that enforcement is too hard. The changes being made at the Federal level will assist here as it will stem the flood of products entering Australia. In addition, I find it disconcerting that something being too hard is reason enough to condemn a new generation to e-cigarette use.
In recent focus groups I conducted with 14- to 39-year-old vapers and non-vapers, I asked them what we needed to do to address rising use. They commented about the availability of these products, and they named the stores/franchises that were represented in this morning’s session. They told us that banning these products is key. While they agreed that education is important, they said that while these products are still available to them – including from stores that claim to be responsible retailers – use will continue. Education in schools simply places the burden on teachers to manage this crisis and I think they have enough to deal with.
A few other points in response to questions from the committee that I have noted: Of the adolescents who attended the focus groups I conducted, they wanted the nicotine, they wanted the head spins. They couldn’t understand why non-nicotine e-cigarettes exist.
Finally, in terms of where kids are sourcing these products from, research I have conducted with adolescents shows that half are accessing these products from friends, but the next highest source category at 20% is tobacconists. So called responsible retailers.
Image: Gabriel Ramos/Unsplash